Drug Use Statistics in the United States | September 2024 Rehab Report

Addiction is no respecter of borders. It impacts every region, every state, and every community. But how, who, and where addiction strikes can vary widely from state to state and city to city. The data below represent state based drug and alcohol use statistics key categories, including the number of overdoses and deaths, drug involved crimes, narcotics violations, and illicit drug use statewide.

Information from each data category has been aggregated into an overall state ranking that reflects the overall impact of addiction in each state. The higher the state’s aggregate score, the more severely the state has been impacted by drug and/or alcohol misuse.

New York, Hawaii, and Montana have the lowest aggregate scores of the 50 U.S. states plus the District of Columbia. Across all categories, these states have the fewest reported incidents of drug related crime, overdoses, narcotics violations, and opioid emergencies. Southern states, however, have the highest aggregate scores and appear to be most detrimentally affected by addiction, particularly relating to the opioid epidemic. According to these statistics, Tennessee, South Carolina, Kentucky, Louisiana, and North Carolina continue to bear the brunt of the drug crisis in the United States. Data for these rankings were aggregated from the following sources: ^{1, 2, 3, 4, 5, 6, 17, 20}

Although addiction is an equal opportunity adversary, this does not mean that all demographics are impacted in the same way. Variations in dependency type, risk factors, and effects are strongly influenced by factors such as age, gender, ethnicity, and socioeconomic status.

The data below indicate, for example, that young adults, those between the ages of 18 and 25, report the greatest amount of drug and alcohol use, with that number steadily declining with age. A notable exception to this, however, is in the number of binge drinking incidents, which appear to peak in the 26-34 age group, followed by a steady decline.

Gender and ethnicity also appear to correlate with variations in drug and alcohol use, with members of the Asian community exhibiting the lowest rates of binge drinking and drug related ER visits. Males exhibit higher incidence rates among all drug and alcohol use categories than females, including more binge drinking events and increased drug related ER visits.

Socioeconomic status seems to be another factor influencing drug and alcohol use, according to the data. The statistics indicate a higher prevalence of drug and alcohol use and drug related ER visits among persons with a median household income between $10,000 and $40,000 annually. Significantly, however, the data also show more binge drinking events among those in middle and upper income brackets than among those earning less than $30,000. Approximately 30 percent of persons earning $75,000 or more report at least one binge drinking event in the previous 12 months. ¹³

Drug overdoses remain a serious issue in the United States. Prescription and illicit drug abuse claim thousands of lives annually, with heroin and synthetic opioids, such as fentanyl, contributing significantly to the surging mortality rate. According to the Drug Enforcement Administration (DEA), the synthetic opioid is estimated to be 100 times more potent than morphine and 50 times as potent as heroin. The DEA estimates that just 2mg of fentanyl, approximately the size of the tip of a pencil, is enough to kill the average healthy adult. They also estimate that over 376 million lethal doses of fentanyl were confiscated in 2023 alone. That’s nearly enough to take the life of every man, woman, and child in the United States.

Perhaps not surprisingly, states with the highest numbers of accidental overdoses and drug related deaths also tend to be most affected by the ongoing opioid epidemic. With the majority of lethal overdoses linked to synthetic opioid misuse, Southern and mid Atlantic states, where the opioid epidemic has hit hardest, also represent the highest number of drug fatalities. This includes Tennessee, West Virginia, Louisiana, and Delaware, as well as the District of Columbia. ¹

As critical as it is to understand how alcohol and drug misuse impact the population on the state level, recognizing the impact on communities, neighborhoods, and cities is even more eye opening. It is important to note, for example, that the cities with the lowest rates of drug use are located in two of the nation’s most populated states: California and Texas. This includes El Paso, San Jose, Oakland, San Antonio, and Houston with the lowest prevalence of per capita drug use in the United States.

Conversely, but perhaps unsurprisingly, the cities with the highest per capita rates of drug use are all located in regions where the opioid epidemic continues to rage. Cities in the Midwest and along the East Coast exhibit the highest drug use rates, with Milwaukee, Baltimore, and Indianapolis faring the worst. In Milwaukee, for instance, there were a reported 78.1 drug overdoses per every 100,000 persons in 2023. In Baltimore, the rate of drug overdoses exceeded 133 per 100,000 people in the same year. ^{6, 7, 8, 14, 18}

The states exhibiting the highest prevalence of drug and alcohol misuse are located primarily in the Midwest and South. They include Tennessee, South Carolina, Louisiana, Kentucky, and North Carolina.

States in the Northeast and Northern Plains represent some of the lowest rates of drug use. These include New York, New Jersey, and Montana. Second in the nation for the lowest rates of drug use is Hawaii, with an aggregate score of 62 out of 100 in total overdoses, narcotics violations, opioid incidents, and rehab admissions. ^{1, 2, 3, 4, 5, 6, 17, 20}

Addiction takes a devastating toll on an individual’s physical and mental health and on their personal relationships, but the economic impacts of addiction are also profound. Addiction disorders cost individual taxpayers hundreds of dollars annually due to lost workforce productivity and surging demand for addiction related medical care, mental health support, and social service programs.

The data indicate that individual taxpayer costs related to addiction have risen by nearly $100 in the 10 year span between 2012 and 2022. The increase may reflect the surge in medical and mental health care costs, speaking to the urgent need for addiction education and prevention programs to reduce addiction related expenditures while also saving lives. ^{9, 10}

Addiction disease often targets society’s most vulnerable populations, and the nation’s homeless communities are no exception. Unhoused persons are at a significantly higher risk than the general population of developing substance use disorder (SUD), engaging in high risk addiction related behaviors, and experiencing life threatening adverse events, from overdose to drug related infections, such as HIV, hepatitis C, and MRSA.

Despite the myriad risks unhoused persons face, it’s the risk of lethal drug overdose that poses the greatest threat. An estimated one fourth of all deaths among the homeless population are attributed to drug overdose. States and districts with the largest homeless populations also typically experience the highest rates of drug related fatalities. Washington D.C. leads the nation in both per capita homeless rates and the number of lethal overdoses within the homeless population. The District of Columbia accounts for 659 homeless persons and more than 40 overdose related deaths among the homeless community per 100,000 people. ^{11, 12}

Addiction can strike anyone, anywhere, at any time. No population or age group is immune. But certain populations are statistically at an increased risk of developing substance use disorders, principally due to histories of personal and/or generational trauma. ¹³

The U.S. border has long been recognized as a principal site of illicit drug activity, specifically cross border drug trafficking. In recent years, the number of drug seizures at the U.S. border has skyrocketed with the surge encompassing all drug types, including marijuana and fentanyl.

At the end of 2023, the number of illicit drug seizures was on the rise, with methamphetamine, marijuana, and cocaine seizures leading the pack. In December of that year, more than 11,000 lbs of meth, 9,500 pounds of marijuana, and 6,000 pounds of cocaine were intercepted or confiscated at the U.S. border.

This does not mean, however, that seizures of other illicit substances have proven less problematic. Indeed, though a comparatively small amount of fentanyl was intercepted at the border in the same month – just over 2,400lbs – the extreme potency of the drug renders even a minute quantity more lethal than most other substances. ¹⁹

Adolescence and young adulthood are a time of experimentation and exploration. For many young people, this period of transition into adulthood often includes experimentation with drugs and alcohol, laying the groundwork for a pattern of abuse and misuse that can quickly spiral into dependency. ^{15, 16}